This form is to help you to decide whether or not you would like to take part in this study. Please complete it after you have read the Participant Information Sheet and submitted your Enrolment Form. Write your initials in each of the boxes if you agree with the statements. If you would prefer to complete a paper version of this form, please contact us.

Hearing bolt-on consent form

By signing this form, I confirm that (please initial the boxes):

I have read the Participant Information Sheet describing the study, or it has been read to me. *

I have read the GDPR Privacy Notice regarding the use of my data, or it has been read to me. *

I have had the opportunity to consider the information, ask questions and have had these answered to my satisfaction. *

I understand that I can withdraw from the study at any time without giving a reason. *

I understand that taking part in this study may involve a focus group or an interview that will be recorded as audio and transcribed as text. *

I know that I can ask the researchers for further information about the study at any time. *

I understand that all information I provide will be considered confidential and that it will not be possible to identify any individual participants in the reporting of the study. *

I understand that quotations from the study might be used in the final report and other research outputs. *

I give permission for de-identified (anonymous) data and quotations that I provide to be used for future research and learning. *

I agree to participate in the study as outlined to me. *

Name of research participant: (your full name) *

Your email address *

We use this field to match your consent form to your enrolment form

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